Diet talk: We see and hear it everywhere. The media applauds “clean eating,” while your next-door neighbor sings the praises of low-carb, and your aerobics instructor endorses anything low-fat. It’s exhausting. Dieting and restriction not only contribute to the development of disordered eating and eating disorders, but they also have negative impacts on female reproductive health. A powerful example is the growing number of women experiencing amenorrhea, or missing menstrual cycles. 

Medically speaking, there are two sub-types of amenorrhea: primary and secondary. Primary amenorrhea is common among young female athletes as well as those who dieted or experienced anorexia nervosa throughout their adolescent years. Here, a woman does not have a period before the age of sixteen or secondary sexual characteristics by the age of fourteen. Secondary amenorrhea occurs among women who have had a period in the past but have been missing their cycle for at least three months. While amenorrhea has several etiologies, hypothalamic amenorrhea is one of the most common.

Put simply, hypothalamic amenorrhea occurs due to some combination of under-eating, over-exercising, or experiencing psychological stress. Unfortunately, this diagnosis often comes with a prescription of Oral Contraceptive Pills. This is an inappropriate treatment for hypothalamic amenorrhea, as it masks rather than heals the root cause(s). Many patients are told not to worry about their missing periods, and most receive little to no counseling around how dieting, over-exercise, and stress disrupt the menstrual cycle. This needs to change. Hypothalamic amenorrhea has many negative health consequences when left unaddressed, including premature osteoporosis/osteopenia and stress on both the brain and the heart. 

Nicola Rinaldi, PhD stands on the frontiers of hypothalamic amenorrhea research, treatment, and advocacy. She is the author of one of our most frequently recommended books, No Period. Now What? and joined us for a members-only webinar in January 2018. In Nicola’s words: “If you are under-fueling for your body’s basic needs and activities, you could lose your period. It has nothing to do with your body size.” When it comes to hypothalamic amenorrhea recovery, the bottom line is this: The body needs rest, food, and patience to heal. ALL bodies deserve healthy relationships with food, body, and movement. Dieting need not apply. 

Interested in learning how to apply a patient-centered approach for the treatment of hypothalamic amenorrhea? You can purchase No Period. Now What? here, and watch “Amenorrhea and Infertility: A Novel Patient-Centered Approach” in our members-only webinar library. We also have a free webinar available with Nicola for members and non-members alike. Find “Impacts of Weight Stigma on the Treatment of Amenorrhea” on our Free Training page. Happy learning!

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